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Title: Usefulness of intraoperative parathyroid hormone measurements in patients with renal hyperparathyroidism.
Author(s): Freriks, K. ; Hermus, A.R.M.M. ; Sevaux, R.G.L. de ; Bonenkamp, J.J. ; Biert, J. ; Heijer, M. den ; Sweep, F.C. ; Hamersvelt, H.W. van
Publication year: 2010
Source: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, vol. 32, iss. 10, (2010), pp. 1328-1335
ISSN: 1043-3074
Publication type: Article / Letter to editor

Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/87546   http://hdl.handle.net/2066/87546

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Subject: IGMD 6: Hormonal regulation
NCEBP 1: Molecular epidemiology
NCEBP 2: Evaluation of complex medical interventions
IGMD 9: Renal disorder
Organization: Endocrinology
Nephrology
Surgery
Epidemiology, Biostatistics & HTA
General Internal Medicine
Laboratory of Genetic, Endocrine and Metabolic Diseases
Journal title: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck
Volume: vol. 32
Issue: iss. 10
Page start: p. 1328
Page end: p. 1335
Abstract:
BACKGROUND: In renal hyperparathyroidism, it remains unclear whether intraoperative parathyroid hormone (PTH) measurements can predict postoperative outcome and guide the extent of surgical exploration. METHODS: In 42 parathyroidectomies for renal hyperparathyroidism, we analyzed the predictive value of the Miami Criterion of 50% intraoperative PTH decrease. We used receiver operating characteristic (ROC) curves to find the criterion with the best diagnostic performance. We also investigated whether the whole PTH assay improved accuracy. RESULTS: Twenty-six operations (62%) resulted in normal postoperative PTH. With the Miami Criterion, cure was predicted with a sensitivity of 95% and specificity of only 8%. Specificity could be improved to 50% using a 70% PTH decrease as cut-off level. The whole PTH assay did not improve accuracy. CONCLUSION: Prediction of cure after parathyroidectomy for renal hyperparathyroidism might be improved with a criterion of 70% PTH decrease 10 minutes after excision of all parathyroid glands. Prospective analysis needs to validate this new criterion.

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